title: Mitoxantrone and high-dose cytosine arabinoside for the treatment of refractory acute lymphocytic leukemia.
abstract: Twenty-five adult patients with refractory acute lymphocytic leukemia received salvage therapy with mitoxantrone 5 mg/m2 intravenously over 1 hour daily for 5 days and cytosine arabinoside 3 g/m2 intravenously over 2 hours every 12 hours for six doses. Overall, nine patients (36%) achieved complete remission, eight (32%) died during induction, and eight (32%) had resistant disease. No significant associations were found between pretreatment patient characteristics and remission. Remission durations toxic effects were related to myelosuppression. Febrile episodes requiring hospitalization occurred in 23 patients (92%), including five episodes of fever of unknown origin (20%) and 18 episodes of documented infections (72%). The authors conclude that the combination of mitoxantrone and high-dose cytosine arabinoside has significant activity in adults with refractory acute lymphocytic leukemia. The addition of colony-stimulating growth factors to the intensive chemotherapy, and the use of the combination regimen as part of front-line maintenance intensification therapy may further improve the prognosis in these patients.
authors.affiliation: University of Texas M. D. Anderson Cancer Center, Department of Hematology, Houston 77030.
authors.forename: H M
authors.initials: HM
authors.lastname: Kantarjian
authors.forename: R L
authors.initials: RL
authors.lastname: Walters
authors.forename: M J
authors.initials: MJ
authors.lastname: Keating
authors.forename: E H
authors.initials: EH
authors.lastname: Estey
authors.forename: S
authors.initials: S
authors.lastname: O'Brien
authors.forename: J
authors.initials: J
authors.lastname: Schachner
authors.forename: K B
authors.initials: KB
authors.lastname: McCredie
authors.forename: E J
authors.initials: EJ
authors.lastname: Freireich
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003561:Cytarabine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate
chemical_list: D003561:Cytarabine; D008942:Mitoxantrone